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Table 3 Quality domains used in key clinical guidelines, quality indicator development projects and systematic reviews

From: Identifying models of delivery, care domains and quality indicators relevant to palliative day services: a scoping review protocol

Author and year

Country/areaa

Population

Total number of quality domains (indicators or recommendations)

Quality domains

van der Steen JT et al. European Association for Palliative Care (EAPC). White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliat Med. 2014 Mar;28(3):197–209.

Europe

Older adults with dementia

11 [57]

Applicability of palliative care

Person-centred care, communication and shared decision making

Setting care goals and advance planning

Continuity of care

Prognostication and timely recognition of dying

Avoiding overly aggressive, burdensome or futile treatment

Optimal treatment of symptoms and providing comfort

Psychosocial and spiritual support

Family care and involvement

Education of the health care team

Societal and ethical issues

Uphoff EP et al. Development of generic quality indicators for patient-centred cancer care by using a RAND modified Delphi method. Cancer Nurs. 2012 Jan-Feb;35(1):29-37.

Holland

Adults with cancer

5 [17] QIs developed from 92 initial recommendations

Communication

Physical support

Psychosocial care

After-care

Organisation of care

Leemans K et al. Towards a standardised method of developing quality indicators for palliative care: protocol of the Quality indicators for Palliative Care (Q-PAC) study. BMC Palliat Care. 2013 Feb 8;12:6.

Belgium/Holland

Palliative care

9 [53]

Assessment and treatment of symptoms

Assessment and treatment of psychological problems

Assessment and treatment of spiritual and religious problems

Informing patients and their family members

Care planning with patients and family members

Treatment and end of life decisions

Type of care and circumstances of dying

Family support

Continuity of care

National Consensus Project for Quality Palliative Care, Clinical Practice Guidelines for Quality Palliative Care, 2013

USA

Palliative care

8 [27]

Structure and processes of care

Physical aspects of care

Psychological and psychiatric aspects of care

Social aspects of care

Spiritual, religious and existential aspects of care

Cultural aspects of care

Care of the imminently dying patient

Ethical and legal aspects of care

National Quality Forum: A National Framework and Preferred Practices for Palliative and Hospice Care Quality. Washington, DC, National Quality Forum, 2006

USA

Palliative care

8 [33]

Structures and processes of care

Physical aspects of care

Psychological and psychiatric aspects of care

Social aspects of care

Spiritual, religious and existential aspects of care

Cultural aspects of care

Care of the imminently dying patient

Ethical and legal aspects of care

McCusker M et al. Institute for Clinical Systems Improvement. Palliative Care for Adults. Updated November 2013.

USA

Palliative care

5 [13]

Patient presents with new or established diagnosis of a serious illnessb

Initiate palliative care discussionb

Assess patient’s palliative care needs

Physical aspects of care

Cultural aspects of care

Psychological and psychiatric aspects of care

Social aspects of care

De Roo ML et al. Quality indicators for palliative care: update of a systematic review. J Pain Symptom Manage. 2013 Oct;46(4):556-72.

EURO IMPACT Belgium/Holland

Palliative care

8 [33]

Structure and process of care

Physical aspects of care

Psychological and psychiatric aspects of care

Social aspects of care

Spiritual, religious and existential aspects of care

Cultural aspects of care

Care of the imminently dying patient

Ethical and legal aspects of care

Mularski RA et al. Proposed quality measures for palliative care in the critically ill: a consensus from the Robert Wood Johnson Foundation Critical Care Workgroup. Crit Care Med 2006;34(11 Suppl):S404eS411.

USA

Palliative care

7 [18]

Patient and family-centred decision making

Communication within the team and with patients and family

Continuity of care

Emotional and practical support for patients and family

Symptom management and comfort care

Spiritual support for patients and family

Emotional and organisational support for clinicians

Dy SM et al. Measuring what matters: top-ranked quality indicators for hospice and palliative care from the American academy of hospice and palliative medicine and hospice and palliative nurses association. J Pain Symptom Manage. 2015 Apr;49(4):773-81

USA

Palliative care

9 [10]

Structure and processes of care

Physical aspects of care

Psychological and psychiatric aspects of care

Social aspects of care

Spiritual, religious and existential aspects of care

Cultural aspects of care

Care of the patient at the end of life

Ethical and Legal Aspects of care

Global measures

National Institute of Clinical Excellence (NICE). 2004. Guidance on Cancer Services Improving Supportive and Palliative Care for Adults with Cancer. The Manual.

UK

Palliative care

12 [20]

Co-ordination of care

User involvement

Face-to-face communication

Information

Psychological support services

Spiritual support services

General palliative care services, including care of dying patients

Specialist palliative care services

Rehabilitation services

Complementary therapy services

Services for families and carers, including bereavement care

Workforce development

van Riet Paap J et al. IMPACT research team. Consensus on quality indicators to assess the organisation of palliative cancer and dementia care applicable across national healthcare systems and selected by international experts. BMC Health Serv Res. 2014 Sep 17;14:396.

Holland

Palliative cancer and dementia care

7 [23]

Access to palliative care

Infrastructure

Assessment tools

Personnel

Documentation of clinical data

Quality

Education

Vasse E et al. The development of quality indicators to improve psychosocial care in dementia. Int Psychogeriatr. 2012 Jun;24(6):921-30.

Holland

Dementia

4 [12]

Diagnosis and assessment

Care plan and treatment

Behavioural problems

Caregivers

Woitha K et al. Validation of quality indicators for the organization of palliative care: a modified RAND Delphi study in seven European countries (the Europall project). Palliat Med. 2014 Feb;28(2):121-9.

Holland (Europal)

Palliative care

6 [56]

Definition of a palliative care service

Access to palliative care

Assessment tools

Personnel in palliative care services

Quality and safety

Reporting clinical activity of palliative care services

  1. NICE National Institute for Clinical Excellence
  2. aBased on first author location
  3. bNot included as domains